Saturday, March 5, 2011

Gallbladder Awareness Campaign

I would like to request that whoever is teaching the medical community that gallbladder problems are only for the over-forty set, to please stop it.  After my previous post, I got tired enough of severe abdominal pain after eating that I decided to keep bothering my doctor until he figured it out and fixed it.

Symptoms, for at least ten years previous, include occasional sharp stabbing aching pain in my torso, near enough to my stomach that I was told it was "just gas".  Pain started 20 minutes to 45 minutes after eating a rich meal, and lasted a few hours, then went away completely.  Sometimes the next few meals would also cause pain, even if they were not rich or fatty.  I'd told my doctors, and nurses, and family, but no one could figure out what was really wrong.  They would test my thyroid again, even though I'd already had it tested and everything was normal.  They would suggest it was a food sensitivity, or an allergy to a preservative, and I had to keep food diaries and do tests.  Nothing made sense, and everything came back normal.

Finally, I had an attack of the pain while I was at the doctor's office, after drinking a glass of water.  He poked around my torso until I yelled out in pain.  "Oh, wow, it is your gallbladder!" he said, then prescribed an ultrasound to look for gallstones.

I went to the medical reference section of the local library to start learning about WTH a gallbladder was.  It turns out to not be very important, but can hurt a lot for various reasons.

The ultrasound was totally normal, no gallstones, no obvious malformations.  Strike out on that one.  The doctor prescribed a HIDA scan, which is where they give you an IV of radioactive tracer and watch you under a gamma camera for two hours to see where it goes.  My liver did it's job, and pulled all of the tracer out of my bloodstream very quickly.  It then slowly, properly, seeped into the small intestine.  The gallbladder never lit up at all.  (They didn't bother with the CCK IV because there would be nothing to see.)  That is not normal, so we finally had a diagnosis.  Biliary dyskinesia, aka "It doesn't work right."

I ended up having surgery to have the non-essential organ removed.  It went well, was done laparoscopically, and I have been free of that pain since.

The medical people who could have recognized my symptoms would usually tell me they didn't suspect my gallbladder because I wasn't OLD ENOUGH.  Here is what I think: people over 40 that get gallbladder attacks go to the emergency room because they think they are having a heart attack, so they get diagnosed more often.  An anecdotal sampling of my facebook friends turned up six other people who had gallbladders removed before they were forty. My doctor told me recently that in the months following my diagnosis, he has found biliary dyskinesia in three other patients, who he hadn't known what to look for before.  So, my point is that the age boundary of 40 years old is probably a red herring, and shouldn't be trusted to rule out this problem in patients with abdominal pain.

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